[Show abstract][Hide abstract] ABSTRACT: Objectives:
We conducted a cross-sectional study to evaluate the socioeconomic systems supporting outpatients with Parkinson's disease (PD) in Japan.
The study was performed in 2013 at two private hospitals and one clinic in Hokkaido Prefecture, Japan. A survey was conducted with 248 consecutive PD patients, and the data from 237 PD outpatients were analyzed after excluding 11 patients who did not meet inclusion criteria. Monthly medical and transportation payments as a PD outpatient were selected as outcome variables, and their association with various explanatory variables, such as utilization of support systems for PD outpatients, were evaluated using logistic regression model analysis.
After controlling for potential confounding variables, the utilization of the system providing financial aid for treatment for patients with intractable disease was significantly inversely associated with monthly medical payment among PD outpatients (OR 0.46; 95% CI, 0.22-0.95). Experience of hospital admission for PD treatment was significantly positively associated with monthly transportation payment (OR 4.74; 95% CI, 2.18-10.32). Monthly medical payment was also significantly positively associated with monthly transportation payment (OR 4.01; 95% CI, 2.23-7.51).
Use of Japanese public financial support systems may be associated with reductions in medical payments for PD outpatients. However, those systems may not have supported transportation payments, and higher transportation payments may be associated with an increased risk of hospitalization.
Preview · Article · Jan 2016 · Journal of Epidemiology
[Show abstract][Hide abstract] ABSTRACT: We genotyped 2 SNPs (rs3790844 T/C and rs3790843 G/A) in the NR5A2 gene that were identified in a genome-wide association study (GWAS) of pancreatic cancer in populations of mainly European ancestry, and we examined their associations with pancreatic cancer risk in a case-control study of 360 patients and 400 control subjects in Japan. Unconditional logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). The SNPs were in linkage disequilibrium (r 2 = 0.80). For rs3790843, the multivariable-adjusted OR was 0.75 (95% CI: 0.41-1.36) and 0.60 (95%CI: 0.33-1.08) for subjects with the AG and AA genotype, respectively, compared to subjects with the GG genotype. The per allele OR was 0.78 (0.62-0.99) (P = 0.046). For rs3790844, the multivariable-adjusted OR was 0.65 (95% CI: 0.37-1.14) and 0.47 (95%CI: 0.27-0.83) for subjects with the CT and CC genotype, respectively, compared to subjects with the TT genotype. The per allele OR was 0.70 (0.56-0.89) (P = 0.003). Our case-control study found that rs3790843 and rs3790844 in the NR5A2 gene are associated with pancreatic cancer risk in Japanese subjects. The direction of association is consistent with the prior findings from GWASs.
Full-text · Article · Nov 2015 · Scientific Reports
[Show abstract][Hide abstract] ABSTRACT: Background
Preoperative chemotherapy is a promising strategy for downstaging advanced gastric cancer before radical resection, although severe adverse events can occur and clinical outcomes are often unsatisfactory. To identify predictive biomarkers of drug sensitivity, we used a well-designed functional apoptosis assay and assessed the correlations between chemosensitivity and clinical outcomes.
Drug sensitivity to docetaxel, cisplatin, and 5-fluorouracil was examined in 11 gastric cancer cell lines. BCL2-homology domain 3 (BH3) profiling was performed and assessed for correlations with drug sensitivity. Immunohistochemical staining of clinical gastric cancer specimens was performed before preoperative chemotherapy, and correlations with histopathological responses and clinical outcomes were assessed.
BIM (BCL2L11)-BH3 profiling results correlated with docetaxel sensitivity and BAK protein expression, whose knockdown caused docetaxel resistance. The BAK expression indexes of 69 gastric cancer specimens before preoperative chemotherapy (including docetaxel treatment) were determined by multiplying numerical values describing the degrees of BAK positivity and staining intensity observed. Patients whose specimens showed good chemotherapeutic histopathological responses had higher BAK indexes than those with poor responses. Patients with BAK index values ≥3 showed improved progression-free survival (HR, 2.664; 95 % CI, 1.352–5.248; P = 0.005) and overall survival (HR, 3.390; 95 % CI, 1.549–7.422; P = 0.002).
BH3 profiling clearly showed that BIM expression, which depends on BAK expression, correlated with docetaxel sensitivity. BAK expression in gastric cancer is thus predictive of chemotherapeutic responses to docetaxel and clinical prognosis in patients treated with preoperative chemotherapy.
[Show abstract][Hide abstract] ABSTRACT: Aims
We assessed the impact of the combination of type 2 diabetes (T2DM) and smoking on total cancer mortality using cohort data of a general Japanese population.
Of 1908 residents who received health checkups in two towns in 1994, 794 males were included as study participants. Smoking status was defined as three categories: never smoker, ex-smoker and current smoker. Individuals with T2DM were defined as individuals with fasting plasma glucose ≥7.0 mmol/l and/or receiving medication for T2DM. Participants were divided into six groups according to T2DM and smoking status: non-DM (NDM) and never smoker, NDM and ex-smoker, NDM and current smoker, DM and never smoker, DM and ex-smoker, and DM and current smoker groups. All participants were followed up for a maximum of 13 years. We calculated the hazard ratio (HR) using Cox’s proportional hazard model and subhazard ratio (SHR) using competing risk regression analyses in each group.
During the follow-up period, there were 169 all-cause deaths (62 cancer deaths and 40 CVD deaths). When using Cox regression analysis, HRs were higher in the ex-smoker and current smoker groups than in the never-smoker group, and HRs were also higher in the DM groups than in the NDM groups. When using competing risk analysis, SHRs were almost the same as the HRs of Cox regression analysis (DM and ex-smoker 6.06, DM and current smoker 10.12).
The combination of T2DM and smoking is a strong risk factor for total cancer mortality in Japanese men.
No preview · Article · Aug 2015 · Diabetology International
[Show abstract][Hide abstract] ABSTRACT: The aim of this study was to examine the association of serum isoflavones, adiponectin, and insulin levels with ovarian cancer risk.
We gathered cases with histologically confirmed epithelial ovarian cancer at Sapporo Medical University Hospital from October 2010 to September 2012. Potential controls were recruited from female inpatients without any history of cancer or diabetes mellitus in different wards of the same hospital over the same period of time. Serum isoflavones, adiponectin, and insulin levels were measured in order to estimate associations with ovarian cancer risk in a case-control study. Data from 71 cases and 80 controls were analyzed with a logistic regression model adjusting for known risk factors.
A significant reduction in ovarian cancer risk was observed for the high tertile of serum daidzein level versus the low (Ptrend<0.001). A significant reduction in ovarian cancer risk was also observed for the high tertile of serum glycitein level versus the low (Ptrend=0.005). Furthermore, a significant reduction in ovarian cancer risk was observed for the high tertile of serum adiponectin level versus the low (Ptrend=0.004). Conversely, serum insulin level showed significantly elevated risk for ovarian cancer with the high tertile versus the low Ptrend<0.001).
Decreased serum isoflavones levels, such as those for daidzein and glycitein, decreased serum adiponectin levels, and increased serum insulin levels could be shown to be associated with elevated risk of ovarian cancer.
No preview · Article · Jul 2015 · Asian Pacific journal of cancer prevention: APJCP
[Show abstract][Hide abstract] ABSTRACT: Multiple system atrophy (MSA) is an intractable neurodegenerative disorder that is characterized by various combinations of autonomic failure, cerebellar ataxia, and parkinsonism. We conducted an epidemiological study of MSA using the combined data of a national registry system and a postal survey in Hokkaido, Japan. A postal survey was conducted in 2013 based on national registry data from 2006 to 2011. This survey contained the current status of each patient with MSA that had been collected from attending physicians and recorded into a national registry. Survey items included date, outcomes, primary symptoms, and activities of daily living at the last medical examination. Confirmation data of the diagnosis by a board-certified neurologist was also collected. Based on the national registry data, 1,092 patients with MSA were selected as our target population. The response rate of the postal survey was 81 % (885/1,092). After excluding inappropriate responses, 839 patients with MSA were analyzed. Forty-nine percent of the patients were male, and the mean onset age was 62.1 ± 10.4 years. A Kaplan-Meier survival curve revealed that patients with onset symptoms of cerebellar ataxia had a better prognosis than those with onset of parkinsonism or autonomic failure (p < 0.01). Additionally, we found that a higher onset age was associated with poor prognosis. We found that patients with cerebellar ataxia at onset had a better survival prognosis than those with parkinsonism or autonomic failure at onset and that patients with an older age at onset had a worse survival prognosis.
[Show abstract][Hide abstract] ABSTRACT: The aim of this study was to examine whether the combination of abdominal obesity and high serum levels of high-sensitivity C-reactive protein (hsCRP) improves the prediction of new-onset hypertension in the general Japanese population. Participants in the Tanno-Sobetsu study, a prospective cohort study, were enrolled. Of 1516 subjects aged 30 years or older in 2002, those with hypertension or abnormal hsCRP levels were excluded, and the remaining 705 subjects were included in the present analyses. Abdominal obesity (AO) and high hsCRP levels were defined by the Japanese criteria of waist circumference and median hsCRP values, respectively. Subjects were followed up on for a maximum of 4.5 years, and the hazard ratio (HR) for new-onset hypertension was calculated using the Cox proportional hazard model. The HR for new-onset hypertension after adjustment for age, sex, fasting plasma glucose, alcohol intake, smoking, treatment for dyslipidemia and high normal blood pressure at baseline was significantly higher in the group with AO and high hsCRP (HR=1.44, 95% CI: 1.00-2.07) compared with the reference group, a group with no AO and low hsCRP; AO alone or high hsCRP alone was not associated with a significant increase in the HR. Similar trends for the increase in the HR by AO and high hsCRP were observed in separate analyses of men and women, although the differences did not reach statistical significance. Co-presence of AO and a high level of hsCRP is associated with a high risk for new-onset hypertension in the general population.Hypertension Research advance online publication, 19 March 2015; doi:10.1038/hr.2015.27.
No preview · Article · Mar 2015 · Hypertension Research
[Show abstract][Hide abstract] ABSTRACT: Background
Seven-valentpneumococcal conjugate vaccine (PCV7) was introduced to Japan in 2009, andafter that invasive pneumococcal disease has graduallydecreased. However, there is little data on the effectiveness of PCV7 againstacute otitis media (AOM) in Japan.Methods
From 10 daycare centers in Sapporo, Japan, 614 parents participated in the survey. Each parent reported whether their child subject had received one or more dosesof PCV7, and if so, the exact dates of receiving PCV7 were verified by reviewing theirmaternal and child healthhandbooks marked by a pediatrician. An AOMwas diagnosed by anotorhinolaryngologist or pediatrician. Cox's proportional hazard model was used for calculating a hazard ratio (HR) of AOM incidence reduced by PCV7 inoculation.ResultsInoculation of PCV7 significantly reduced the risk of AOM (crude HR=0.63, 95%CI 0.50, 0.79). Adjustingforpotentially confounding variables reduced the risk further(adjusted HR=0.33, 95%CI 0.25, 0.43). Stratified analysis by subject age on April 30, 2012 revealed that PCV7 was significantly associated with a reduced risk of AOM in both infants under 3 years old,andchildren 3 years and over.Conclusion
Our study showedthe effectiveness of PCV7 for reducing therisk of AOMboth in infants under 3 years old, and in young children over 3 years in Japan.
No preview · Article · Jan 2015 · Pediatrics International
[Show abstract][Hide abstract] ABSTRACT: To examine whether diabetes-related genetic variants are associated with pancreatic cancer risk.
We genotyped 7 single-nucleotide polymorphisms (SNPs) in PPARG2 (rs1801282), ADIPOQ (rs1501299), ADRB3 (rs4994), KCNQ1 (rs2237895), KCNJ11 (rs5219), TCF7L2 (rs7903146), and CDKAL1 (rs2206734), and examined their associations with pancreatic cancer risk in a multi-institute case-control study including 360 cases and 400 controls in Japan. A self-administered questionnaire was used to collect detailed information on lifestyle factors. Genotyping was performed using Fluidigm SNPtype assays. Unconditional logistic regression methods were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between these diabetes-associated variants and pancreatic cancer risk.
With the exception of rs1501299 in the ADIPOQ gene (P = 0.09), no apparent differences in genotype frequencies were observed between cases and controls. Rs1501299 in the ADPIOQ gene was positively associated with pancreatic cancer risk; compared with individuals with the AA genotype, the age- and sex-adjusted OR was 1.79 (95%CI: 0.98-3.25) among those with the AC genotype and 1.86 (95%CI: 1.03-3.38) among those with the CC genotype. The ORs remained similar after additional adjustment for body mass index and cigarette smoking. In contrast, rs2237895 in the KCNQ1 gene was inversely related to pancreatic cancer risk, with a multivariable-adjusted OR of 0.62 (0.37-1.04) among individuals with the CC genotype compared with the AA genotype. No significant associations were noted for other 5 SNPs.
Our case-control study indicates that rs1501299 in the ADIPOQ gene may be associated with pancreatic cancer risk. These findings should be replicated in additional studies.
No preview · Article · Dec 2014 · World Journal of Gastroenterology
[Show abstract][Hide abstract] ABSTRACT: The incidence of renal cell carcinoma (RCC) is high in Western and Northern Europe and North America, and low in Asia. Although the incidence of RCC in Japan is lower than the rates in the other industrialized countries, there is no doubt that it is increasing. In this paper, we would like to introduce the summary of findings of JACC study, which evaluate the risk factors for RCC in a Japanese population. JACC study suggests nine risk factors (i.e., smoking, obesity, low physical activity, hypertension, diabetes mellitus, kidney diseases, beef, fondness for fatty food and black tea) and one preventive factor (i.e., starchy roots such as taro, sweet potato and potato) in a Japanese population. In Japan, however, drinking black tea may be a surrogate for westernized dietary habits while eating starchy roots may be a surrogate for traditional Japanese dietary habits. Further studies may be needed to evaluate risk factors for RCC because the number of cases is small in our studies.
Full-text · Article · Nov 2014 · Asian Pacific journal of cancer prevention: APJCP
[Show abstract][Hide abstract] ABSTRACT: In breast cancer, single-photon emission computed tomography/computed tomography (SPECT/CT) shows the exact anatomical location of sentinel nodes (SN). SPECT/CT mainly exposes axilla and partly exposes atypical sites of extra-axillary lymphatic drainage. The mechanism of how the atypical hot nodes are involved in lymphatic metastasis was retrospectively investigated in the present study, particularly at the level II/III region. SPECT/CT was performed in 92 clinical stage 0-IIA breast cancer patients. Sentinel lymph nodes are depicted as hot nodes in SPECT/CT. Patients were divided into two groups: With or without hot node in level II/III on SPECT/CT. The existence of metastasis in level II/III was investigated and the risk factors were identified. A total of 12 patients were sentinel lymph node biopsy metastasis positive and axillary lymph node dissection (ALND) was performed. These patients were divided into two groups: With and without SN in level II/III, and nodes in level II/III were pathologically proven. In 11 of the 92 patients, hot nodes were detected in level II/III. There was a significant difference in node metastasis depending on whether there were hot nodes in level II/III (P=0.0319). Multivariate analysis indicated that the hot nodes in level II/III and lymphatic invasion were independent factors associated with node metastasis. There were 12 SN-positive patients followed by ALND. In four of the 12 patients, hot nodes were observed in level II/III. Two of the four patients with hot nodes depicted by SPECT/CT and metastatic nodes were pathologically evident in the same lesion. Therefore, the present study indicated that the hot node in level II/III as depicted by SPECT/CT may be a risk of SN metastasis, including deeper nodes.
Full-text · Article · Nov 2014 · Experimental and therapeutic medicine
[Show abstract][Hide abstract] ABSTRACT: Background:
It is known that obesity is one of the risk factors for breast cancer although the association may differ between ethnic groups and with the menopausal status. Recently obesity-related risk factors including serum adiponectin and insulin levels have been analyzed together with BMI in association with breast cancer risk.
Materials and methods:
We measured serum high molecular weight (HMW) adiponectin and insulin levels in a hospital based case-control study, including 66 sets of Japanese female breast cancer cases and age and menopausal status matched controls. Serum levels of HMW adiponectin, insulin levels and body mass index (BMI) were examined in association with breast cancer risk with adjustment for the various known risk factors by menopausal status.
Women in the highest HMW adiponectin levels showed significant reduced risk of breast cancer in both pre and postmenopausal women (odds ratio (OR), 0.01; 95% confidence interval (CI), 0.00-0.26 and 0.13; 0.03-0.57, respectively). Lower BMI showed decreased breast cancer risk in both pre and postmenopausal women (OR, 0.04; 95% CI, 0.00-0.69, OR, 0.28; 95% CI, 0.07-1.11, respectively).
These results indicated that higher serum HMW adiponectin levels and lower BMI are associated with a decreased breast cancer risk in both pre and postmenopausal women in Japan, adding evidence for the obesity link.
No preview · Article · Oct 2014 · Asian Pacific journal of cancer prevention: APJCP
[Show abstract][Hide abstract] ABSTRACT: The aim of the present study was to evaluate whether preoperative computed tomography (CT) is a useful modality for the diagnosis of axillary lymph node metastasis. The axillary lymph node status was examined in patients with primary breast cancer who had undergone surgery. In total, 75 patients were analyzed with preoperative contrast CT images, following which the patients underwent an intraoperative sentinel lymph node biopsy to determine possible predictors of axillary lymph node metastasis. The lymph node shape was classified into three groups, which included fat-, clear-and obscure-types. Multivariate analysis revealed that clear-type lymph nodes in preoperative contrast CT imaging may be an independent predictor of lymph node metastasis (odds ratio, 15; P=0.003). Therefore, the results indicated that preoperative CT examination is useful to predict axillary lymph node metastasis.
Full-text · Article · Aug 2014 · Experimental and therapeutic medicine
[Show abstract][Hide abstract] ABSTRACT: Background:
Isoflavones, which are included in soybeans, have been suggested to protect against prostate cancer. Equol, one of isoflavones, is an intestinally derived bacterial metabolite of daidzein. A newly identified equol-producing bacterium, Slackia sp. strain NATTS, with a high equol-producing activity was isolated from human feces in Japanese adults. Counts of Slackia sp. strain NATTS in intestinal flora have not been assessed with regard to prostate cancer risk. In this study, we investigated the association of serum isoflavones and counts of Slackia sp. strain NATTS with prostate cancer risk in a case-control study.
Materials and methods:
Concentrations of isoflavones and counts of Slackia sp. strain NATTS in feces were measured from 44 patients with prostate cancer and 28 hospital controls. The risk of prostate cancer was evaluated in terms of odds ratios (ORs) and 95% confidence intervals (CIs) by the logistic regression analysis.
The detection proportions of Slackia sp. strain NATTS in cases and controls were 34.1% and 25.0%, respectively. Counts of Slackia sp. strain NATTS were significantly correlated with serum concentrations of equol both in cases and controls (Spearman correlation coefficients, rs=0.639 and rs=0.572, p<0.01, respectively). Serum concentrations of genistein, daidzein, glycitein, and equol were not significantly associated with risk of prostate cancer.
This study found that counts of Slackia sp. strain NATTS correlated with serum concentrations of equol both in prostate cancer cases and controls, but serum isoflavone concentrations were not associated with risk of prostate cancer in our patients.
No preview · Article · Mar 2014 · Asian Pacific journal of cancer prevention: APJCP
[Show abstract][Hide abstract] ABSTRACT: For sentinel lymph node biopsy (SLNB), a combination of dye-guided and γ-probe-guided methods is the most commonly used technique. However, the number of institutes in which the γ-probe-guided method is able to be performed is limited, since special equipment is required for the method. In this study, SLNB with the dye-guided method alone was evaluated, and the clinicopathological characteristics were analyzed to identify any factors that were predictive of whether the follow-up axillary lymph node dissection (ALND) was able to be omitted. A total of 374 patients who underwent SLNB between 1999 and 2009 were studied. The SLN identification rate was analyzed, in addition to the false-positive and false-negative rates and the correlation between the clinicopathological characteristics and axillary lymph node metastases. The SLN was identified in 96.8% of cases, and, out of the patients who had SLN metastasis, 63.0% did not exhibit metastasis elsewhere. The sensitivity was 96.4% and the specificity was 100%. The false-negative rate was 3.6%. Univariate analyses revealed significant differences in the lymph vessel invasion (ly) status, nuclear grade (NG), maximum tumor size and the percentage of the area occupied by the tumor cells in the SLN (SLN occupation ratio) between the patients with and without non-SLN metastasis, indicating that these factors may be predictive of axillary lymph node metastasis. Multivariate analysis revealed that ly status was an independent risk factor for non-SLN metastasis. In conclusion, SLN with the dye-guided method alone provided a high detection rate. The study identified a predictive factor for axillary lymph node metastasis that may improve the patients' quality of life.
Full-text · Article · Feb 2014 · Experimental and therapeutic medicine
[Show abstract][Hide abstract] ABSTRACT: Background:
We aimed to evaluate the role of genetic polymorphisms in tobacco carcinogen-metabolizing genes and their interactions with smoking in a hospital-based case-control study of Japanese subjects.
Materials and methods:
We examine the associations of pancreatic cancer risk with genetic polymorphisms in GSTM1, GSTT1 and GSTP1, phase II enzymes that catalyze the conjugation of toxic and carcinogenic electrophilic molecules. The study population consisted of 360 patients and 400 control subjects, who were recruited from several medical facilities in Japan. Unconditional logistic regression methods were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between genotypes and pancreatic cancer risk.
Among the control subjects, the prevalence of the GSTM1-null genotype and the GSTT1-null genotype was approximately 56% and 48%, respectively. Cases and controls were comparable in terms of GSTM1 and GSTT1 genotype distributions. Neither of the deleted polymorphisms in GSTM1 and GSTT1 was associated with the risk of pancreatic cancer, with an age- and sex-adjusted OR of 0.99 (95%CI: 0.74-1.32) for the GSTM1-null genotype, and 0.98 (95%CI: 0.73-1.31) for the GSTT1-null genotype. The OR was 0.97 (95%CI: 0.64-1.47) for individuals with the GSTM1 and GSTT1-null genotypes compared with those with the GSTM1 and GSTT1- present genotypes. No synergistic effects of smoking or GST genotypes were observed.
Our results indicate no overall association between the GSTM1 and GSTT1 deletion polymorphisms and pancreatic cancer risk in the Japanese subjects in our study.
No preview · Article · Jan 2014 · Asian Pacific journal of cancer prevention: APJCP
[Show abstract][Hide abstract] ABSTRACT: To evaluate the correlation between apparent diffusion coefficient (ADC) and prognosis in head and neck squamous cell carcinoma (HNSCC) treated with radiotherapy.
We retrospectively studied 41 patients (38 male and 3 female, ages 37-85 years) diagnosed with HNSCC (14 oropharynx, 22 hypopharynx, 4 larynx, 1 oral cavity) and treated with radiotherapy, with radiation dose to gross tumor volume over 60 Gy. The association between age, gender, performance status, tumor location, T stage, N stage, stage, dose, overall treatment time, treatment method, adjuvant therapy, or ADC and prognosis was analyzed using a Cox proportional hazard test.
ADC calculated with b-values of 300, 500, 750, and 1,000 s/mm(2) (ADC 300-1,000) alone showed a significant correlation with all of the analyses (p = 0.022 for local control, p = 0.0109 for regional control, p = 0.0041 for disease-free survival, and p = 0.0014 for overall survival). ADC calculated with b-values of 0, 100, and 200 s/mm(2) (ADC 0-200) showed a significant correlation with overall survival (p = 0.0012). N stage showed a significant correlation with regional control (p = 0.0241). Performance status showed significant association with local control (p = 0.0459), disease-free survival (p = 0.023), and overall survival (p = 0.0151), respectively.
ADC is an independent predictor of prognosis in HNSCC treated with radiotherapy.
No preview · Article · Jan 2014 · Japanese journal of radiology
[Show abstract][Hide abstract] ABSTRACT: Background:
Cigarette smoking is the largest single recognized cause of human cancers. In Western countries, many epidemiologists have reported risk factors for kidney cancer including smoking. However, little is known about the Japanese population.
Materials and methods:
We evaluated the association of smoking with the risk of kidney cancer death in the Japan Collaborative Cohort (JACC) Study. Participants included 46,395 males and 64,190 females. The Cox proportional hazards model was used to determine age-and-sex adjusted relative risks.
A total of 62 males and 26 females died from kidney cancer during the follow-up of 707,136 and 1,025,703 person-years, respectively. Heavy smokers (Brinkman index >1200), fondness of fatty foods, hypertension, diabetes mellitus (DM), and obesity were suggested to increase the risk of renal cell carcinoma while walking was suggested to decrease the risk. Even after controlling for age, sex, alcohol drinking and DM, heavy smoking significantly increased the risk.
The present study suggests that six factors including smoking may increase and/or reduce the risk of kidney cancer in the Japanese population. Because of the small number of outcomes, however, we did not evaluate these factors after adjusting for all possible confounding factors. Further studies may be needed to confirm the findings in this study.
No preview · Article · Nov 2013 · Asian Pacific journal of cancer prevention: APJCP